More on Tentative Physician Services Agreement
Last week, we reached a tentative Agreement with the government for an historic level of new funding for physicians over the next four years. This week, we want to help you learn more and share what we are hearing from members and the questions coming in too.
With a record $268 million over four years, the Agreement includes:
- $153 for general rate increases, including a market adjustment in year 1 followed by 2% annual increases in years 2, 3 and 4. It also includes a one-time $21,000 special retention payment following ratification.
- $50 million for specialists and hospital care, including new hospital premiums, increased on-call premiums, significant funding for bloc-specific concerns, and more.
- $50 million for family physicians, including a new longitudinal practice model, a new tariff for extended visits, a simplified fee structure, and more.
- $15 million for shared priorities for both specialists and family physicians.
Remember, voting opens August 1 and closes at 11:59AM on August 14. You should receive a personal, secure, anonymous electronic ballot via email on Tuesday.
Getting You the Answers You Need
We have set up multiple ways for you to learn about what’s in the tentative Agreement. We want to ensure you have the information you need to make an informed choice when voting.
- Read the overview of what’s in this historic tentative Agreement.
- Read the President’s letter, including why the Board has strongly recommended the Agreement to members for ratification.
- Visit our Ratification Information Centre, where you can learn more about what’s in the Agreement for your bloc or group. Please note, if you need help logging in, or if you aren’t seeing all the blocs or alternate funded groups to which you belong, contact us at firstname.lastname@example.org for assistance.
- Watch our webinar about what’s in this Agreement for physicians.
- Contact us with questions at email@example.com.
We are prioritizing questions about the substance of the Agreement to help inform members before voting. Keep sending your very thoughtful technical questions and suggestions, which will be very helpful as we plan to support members through the introduction of many new and enhanced tariffs on October 1, 2023 and April 1, 2024.
What are physicians saying?
We have received a lot of feedback and questions from physicians about the Physician Services Agreement.
“I work in hospital and in the community, and the new hospital premiums and community visit fees all sound very good. It’s a very exciting agreement!”
Internal Medicine Specialist
“I believe that [the new Agreement] reflects our needs well and I feel listened to and heard.”
“I’m happy with the deal that has been negotiated and I think that increasing these fees is the best short-term solution to help bring more doctors to the hospital where they are desperately needed.”
“This Agreement makes people feel validated, which goes a long way to supporting physician health.”
Rural Family Physician
“It’s an amazing agreement!”
“I find the newly negotiated tariffs, and the permanent institution of virtual tariffs to be excellent achievements.”
“This is great news!”
“Please pass on my thanks to everyone on the GREAT deal!”
Rural Family Physician
“It is a good deal for everyone.”
“[The Agreement] almost seems too good to be true. What’s the catch?”
Common questions we are receiving
Who is eligible for the $21,000 Retention Payment and how will it be paid?
- The eligibility is very simple. Any physician who holds a full CPSM license and is a Doctors Manitoba member on ratification day (August 14) qualifies for the $21,000 special retention payment.
- We anticipate being able to send you this payment within a few weeks following ratification. Like our existing Physician Retention Payment, accounting and tax rules require this to be paid to the individual, not to a medical corporation, as personal income. You will also receive a T4A. As personal income, it also means this income is for you, and our understanding is that it should not be subject to any tithing or overhead deductions from clinical income.
Do I have to choose between the existing fee-for-service model and the new longitudinal family practice model?
- We have heard a lot of excitement about Family Medicine Plus, Manitoba’s new longitudinal family practice model. Unlike BC and Nova Scotia, the other two provinces with models like this, in Manitoba you do not need choose between a new LFP model and the existing fee-for-service system. Here, you will continue to access existing fee-for-service tariffs, along with new and enhanced fees, and layer the new LFP components on top. These LFP components include panel payments for all patients, plus a limited time-based stipend for indirect clinical time.
- The new LFP model will be introduced April 1, 2024, and we will be developing transition resources to help you, every step of the way.
Why wasn’t there more progress made with Team-Based Care?
- We were disappointed not to make more progress on team-based care in this new Physician Services Agreement. It is important and has tremendous potential to improve family medicine and specialty practices in both the community and hospital settings.
- This is a challenge across Canada, and we also see other provinces struggling to make progress on team-based care.
- Manitoba is already ahead in some areas, including early adoption of physician assistants and the community Interdisciplinary Team Initiative.
- Please know we aren’t done. We are continuing to press for a leap forward on team-based care, in a way that is connected to physicians’ practices.
What’s in this agreement for community-based specialists?
We have pushed for several advancements that we believe will support community-based specialists, based on your feedback and advice before negotiations. These include:
- Making virtual visits permanent, at 100% of in-person rates. Most provinces reduced virtual visit rates when making them permanent.
- Introducing a new $3.50 in-person visit fee to recognize the added costs and time associated with in-person visits.
- A new tariff for specialists to recognize the continuing care management you provide for patients with one of 30 designated diseases.
- Enhanced fees for eConsultation and collaboration between physicians.
The agreement also includes significant increases for all tariffs and alternate funded agreements. All tariffs will increase by a minimum of 6.1% over four years, but many will receive market adjustments in the first year on top of this. The competitive market adjustments in the first year will ensure all tariffs are at or above the benchmark with other provinces, a threshold we often don’t meet until the last year in previous Agreements.
Can you help me understand how this affects family physicians providing hospital coverage?
- Family physicians play an important role in providing hospital care to patients. There are several different models for coverage in Winnipeg and rural/northern hospitals, including hospitalist, block coverage, HMO, surgical assist, ER coverage, and more. Alternate funded coverage models like these will receive a significant market adjustment in the first year, followed by three years of annual 2% increases. Further, where you claim fee-for-service for in-hospital visits, these will receive a 15% premium starting October 1, 2023. You can find details for the Agreement that applies to your work in the Ratification Information Centre. If you don’t see it, contact us at firstname.lastname@example.org.
Recruiting More Doctors
Earlier this week, the government announced it is moving forward with a new recruiting form to help attract 150 more family physicians to Manitoba. The firm, Canadian Health Labs, will recruit 50 family physicians for Winnipeg, 50 for rural and 50 for northern Manitoba. Doctors Manitoba has worked with Shared Health to ensure community-based physician practices can access recruiting help. More details will follow.
The government also announced a streamlined process for international medical graduates (IMGs) expedite practice in Manitoba. IMGs who meet all other registration requirements will no longer be required to also hold a Licentiate of the Medical Council of Canada to practise in Manitoba. This requirement can be safely removed because specialists and family physicians must continue to demonstrate competency by either completing post-graduate medical education and obtaining certification from either the College of Family Physicians of Canada or Royal College of Physicians and Surgeons of Canada, or by completing the Manitoba Practice Assessment Program. Additionally, applicants who have already completed the Royal College of Physicians and Surgeons of Canada’s Subspecialist Examination Affiliate Program will be eligible for a new fast-track registration process that is more appropriate for their qualifications. This builds on an improvement earlier this year to remove the PCC qualifying exam part 1.
“We are happy to see changes that will make it easier for internationally trained physicians to practise here in Manitoba,” said Dr. Michael Boroditsky, president, Doctors Manitoba. “The changes announced today will remove burdensome and unnecessary steps to obtaining a licence in Manitoba. This will mean well-qualified international medical graduates will be able to practise sooner, which will help to address Manitoba’s physician shortage.”
”We are pleased to eliminate barriers to assessment, without compromising quality and patient safety,” said Dr. Anna Ziomek, registrar, CPSM. “The current regulations for evaluating provisional registrants delay and discourage qualified international medical graduates from practising in Manitoba. With these amendments, regulation will be more adaptable to current workforce challenges and CPSM can better streamline assessment processes and establish requirements for supervision and monitoring.
You can read more about this announcement here.
This member golf tournament is an idea that came to us from members looking for more opportunities to connect with colleagues outside of work.
Don’t wait to register, as space is limited. If you’re putting together a foursome but don’t yet have all the names, you can buy the tickets now and add names and details later.
- When: Tuesday September 5
- Where: Southwood Golf and Country Club in St. Norbert.
- Cost: $190 each, includes a full 18 holes, power cart, lunch and dinner, and more
- Register now!
New to golf? You’re not alone and you’re welcome! The tournament format is friendly for less experienced golf players, with a shotgun start and a best-ball scramble format.
Experienced golfer? You’ll fit in. Southwood is a premier championship course with challenging holes.
Proceeds from the golf tournament will support the Doctors Manitoba public awareness campaigns and resources about healthy living and disease prevention, a physician-led initiative.
If your practice is interested in sponsoring or hosting a hole, please email email@example.com to discuss options and pricing for participation in the event.
Physicians of the Week
Last Week – Dr. Savitra Ramaya
Whether she is responding to a code orange, bringing her colleagues together to connect, or advocating for physicians and patients, Dr. Savitra Ramaya brings her warmth, intelligence, and emotional acumen to the table to benefit everyone. She takes pride in being an advocate for her patients and says,“the most rewarding part of my job is hearing from past patients, even years later, who tell me that I helped them and made a difference in their lives.” Dr. Ramaya is proud of her involvement with the Physician Health and Wellness Community of Practice (PHW CoP) committee for Prairie Mountain Health (PMH). She is the current chairperson for PMH and is excited for her new role of Peer Support Coordinator for the region.
This Week – Dr. Carl Boodman
Dr. Carl Boodman’s work is primarily research-based. His research is focused on often neglected infections that have links to poverty, houselessness and migration. He is passionate about “using research as an advocacy tool to address socioeconomic disparity” and is concerned about “how little we know about diseases that disproportionately affect people experiencing poverty.” He brought national attention to a less obvious and serious consequence of the lack of access to clean water with his co-authored article in the Globe and Mail in February 2023. Dr. Boodman has concerns about the silos in medicine and about the division between research and practice. He believes that more funding should be available for operational research, which bolsters the correlation between knowledge generation, discovery and health outcomes.
Health System Updates
STBBI Provider Form in EMRs
Public Health announced that provider forms for STBBI and/or STI Treatment can now be found within Accuro EMR. The template has been uploaded into the Accuro Form Repository so that regional EMR instances will have access to download the template form. Due to privacy requirements, only pages 1 and 2 (case/client information) will be fillable in EMR, auto-populated with client demographic information. Information about contacts collected on page 3 will continue to be manually recorded on a printed copy of the form and sent to public health. A quick reference guide available here. Read more in this Public Health bulletin.
Diabetes Survey for Physicians
Youville Diabetes Centre in collaboration with health care practitioners is working to identify the gaps in diabetes health care services, education, resources, and supports available for persons living with diabetes. They would like to know what information will be most useful to physicians in Manitoba, in providing care and education for persons living with diabetes. Please complete this short 5 minute survey to provide your feedback.
Protection for Persons in Care Office Being Replaced
In response to a scathing report released yesterday, the government announced it is disbanding the Protection for Persons in Care Office and replacing it with a more independent office that will report to the all-party legislature rather than to the Minister of Health. This improved oversight will address serious concerns raised about the current Office. You can read more here.
New Screening Guidelines for Fragility Fractures
Should you screen to help reduce the risk of fragility fractures? Use a new interactive online Fragility Fracture Decision Aid for shared decision-making, part of a new guideline on screening to prevent fragility fractures. The tool was developed by the Canadian Task Force on Preventive Health Care. The guideline recommends:
- A “risk assessment-first” screening process for women 65 years and older, centred around shared-decision making with their primary care providers
- Women should be informed of their risk and supported in their decisions on further testing and preventive treatment
- Screening is not recommended for females under 65 or males of any age
Resources for Caring with Seniors and Depression
The Canadian Coalition for Senior’s Mental Health is a pan-Canadian agency that promotes the mental health of seniors by connecting people, ideas and resources. They have recently produced resources developed by geriatric psychiatrists to assist physicians in working with seniors with depression. Clinical practice guidelines, clinician pocket cards, patient information pamphlets, and infographics can be found on their website https://ccsmh.ca/projects/depression/.
Health in the News
It’s been a busy few weeks when it comes to health in the news. We’ve curated the top stories for you below.
DRMB In the News
Positive prognosis: docs hail $268M deal Winnipeg Free Press (Print Edition) • Danielle Silva • Jul 21
Manitoba government reaches ‘historic’ agreement with Doctors Manitoba CTV News • Unknown • Jul 21
Doctors offered $268M funding bump Brandon Sun (Print Edition) • Jul 20
Doctors Manitoba, province reach new agreement Global News • Jul 20
Tentative deal with doctors aims to address doctor shortage, retention issues in Manitoba CBC.CA News • CBC News • Jul 20
Real change on way?; Manitoba targets recruitment of 150 family physicians Winnipeg Sun (Print Edition) • Glen Dawkins • Jul 25
Manitoba inks deal to recruit 150 physicians in battle against doctor shortage CBC.CA News • Jul 24
New Manitoba doctors contract makes virtual appointments permanent option Winnipeg Free Press (Print Edition) • Katie May • Jul 27
Other Health News
Addictions services funded, operated by health authorities inadequate, review concludes Winnipeg Free Press (Print Edition) • Danielle Silva • Jul 27
Manitoba has second-worst HIV rate in Canada, demand for resources increasing Power 97 • Nicole Buffie • Jul 26
Filipino workers heading north through provincial project; Health care Flin Flon Reminder (Print Edition) • Eric Westhaver • Jul 26
Barriers for hiring doctors with foreign training being eliminated Winnipeg Free Press (Print Edition) • Katie May • Jul 25
Clinic ordered to halt for-profit ultrasounds after feds claw back Manitoba’s funding over fees CBC Manitoba • Kristin Annable • Jul 24
Province tabs $3M for 17 new psychologist postings Winnipeg Free Press (Print Edition) • Malak Abas • Jul 22
Fewer Culex Tarsalis mosquitoes being found in Manitoba traps SteinbachOnline.com • Jul 21
Manitoba NDP criticizes awarding of air ambulance contract to private firm with PC ties CBC Manitoba • Jul 20
Province unveils diabetes action plan Winnipeg Free Press (Print Edition) • Jul 20
Here are some of the most popular updates in recent newsletters, in case you missed them
- Fall COVID Booster News
- A new colon cancer screening test and requisition form has been rolled out. See the details here.
- Funds Available for Rural Practice Training — The Society of Rural Physicians of Canada has received funding to reimburse rural physicians, including specialists, who are interested in advanced skills training.
- COVID & Flu Vaccine Updates — There’s a new ordering process beginning this fall, Bivalent is now recommended for primary series, and the Janssen vaccine has been discontinued.
- CPSM Fee Rebate applications are open. Learn more.
Events can always be found on our website in the events calendar. If you have an event you’d like to share with members and have included in our calendar, forward all the information to firstname.lastname@example.org.
Federation of Medical Women of Canada Conference
As current President of the Federation of Medical Women of Canada (FMWC), I invite you all to join us at our upcoming AGM & Educational Conference taking place September 23 – 24 in Calgary at the amazing Hotel Arts. Sessions are CFPC and RCPSC accredited and we will be focusing on topics which we think will be very valuable to you such as leadership skills development, advocacy, equity gaps in access, wellness and lots more. There’s also social events and an awards dinner which are great opportunities for networking. While we are always looking to welcome new members to FMWC, you do not need to be a member to attend the educational portion. Student travel awards are being offered and poster session abstracts are now being accepted. Visit www.FMWC2023.com for Registration and all meeting details. To become an FMWC member go to www.FMWC.ca. We hope you will join us for this exciting event!
Dr. Shelley Zieroth
President, Federation of Medical Women of Canada
Bug Day — Mark your calendars for 2023 27th Annual Bug Day! — October 17 7:55am-4pm — Held Virtually.
Interested in the prevention and control of communicable diseases, and health issues in the community or healthcare setting? Bug Day is for you! Nationally and internationally recognized experts will present timely topics in infectious diseases and public health at Manitoba’s largest healthcare education event. Held every year during National Infection Prevention & Control Week, Bug Day is streamed online – it’s FREE, accredited, and you’re invited!
The program is accredited for physicians and can be used for continuing education purposes by other health care workers. There is no charge, but you must register to attend the live sessions. You can make a donation directly to the HSC Foundation Bug Day fund. Click here to visit the donation page. This donation page will automatically generate a confirmation email and a tax receipt. Register here.
Doctors Manitoba Golf Tournament — September 5, 2023
Join us and connect with colleagues at our 2023 Getting Healthy Gold tournament at one of Manitoba’s premier championship courses, offering a fun non-competitive event open to all skill levels. This exciting event is an opportunity to connect with your colleagues. Facilities open at 11am | Lunch service between 11:15am – 12:45pm | Shotgun Start at 1PM | Dinner served following play Register now!